Skip to main content
SpringerLink
Log in

Patient-Reported Outcomes Following Living Kidney Donation: A Single Center Experience

  • Published:
Journal of Clinical Psychology in Medical Settings Aims and scope Submit manuscript

Abstract

This article describes the development and implementation of an initiative at one transplant center to annually assess psychosocial outcomes of living kidney donors. The current analysis focuses on a cohort of adults (n = 208) who donated a kidney at BIDMC between September 2005 and August 2012, in which two post-donation annual assessments could be examined. One and two year post-donation surveys were returned by 59 % (n = 123) and 47 % (n = 98) of LKDs, respectively. Those who did not complete any survey were more likely to be younger (p = 0.001), minority race/ethnicity (p < 0.001), and uninsured at the time of donation (p = 0.01) compared to those who returned at least one of the two annual surveys. The majority of donors reported no adverse physical or psychosocial consequences of donation, high satisfaction with the donation experience, and no donation decision regret. However, a sizable minority of donors felt more pain intensity than expected and recovery time was much slower than expected, and experienced a clinically significant decline in vitality. We describe how these outcomes are used to inform clinical practice at our transplant center as well as highlight challenges in donor surveillance over time.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

Abbreviations

BIDMC:

Beth Israel Deaconess Medical Center

BMI:

Body mass index

LKD:

Living kidney donor

NLDAC:

National Living Donor Assistance Center

OPTN:

Organ Procurement and Transplantation Network

QAPI:

Quality Assessment and Performance Improvement

RCI:

Reliable Change Index

UNOS:

United Network for Organ Sharing

References

  • Bauer, S., Lambert, M. J., & Nielsen, S. L. (2004). Clinical significance methods: A comparison of statistical techniques. Journal of Personality Assessment, 82, 60–70.

    Article  PubMed  Google Scholar 

  • Clarke, K. S., Klarenbach, S., Vlaicu, S., Yang, R. C., Garg, A. X., & Donor Nephrectomy Outcomes Research (DONOR) Network. (2006). The direct and indirect economic costs incurred by living kidney donors: A systematic review. Nephrology Dialysis Transplantation, 21, 1952–1960.

    Article  Google Scholar 

  • Clemens, K.K., Thiessen-Philbrook, H., Parikh, C.R., Yang, R.C., Karley, M.L., Boudville, N., … Donor Nephrectomy Outcomes Research (DONOR) Network.(2006). Psychosocial health of living kidney donors: A systematic review. American Journal of Transplantation, 6, 2965–2977.

  • Davis, C. L. (2012). Living kidney donor follow-up: State-of-the-art and future directions. Advances in Chronic Kidney Disease, 19, 207–211.

    Article  PubMed  Google Scholar 

  • Dew, M. A., & Jacobs, C. L. (2012). Psychosocial and socioeconomic issues facing the living kidney donor. Advances in Chronic Kidney Disease, 19, 237–243.

    Article  PubMed Central  PubMed  Google Scholar 

  • Dew, M. A., Jacobs, C. L., Jowsey, S. G., Hanto, R., Miller, C., & Delmonico, F. L. (2007). Guidelines for the psychosocial evaluation of living unrelated kidney donors in the United States. American Journal of Transplantation, 7, 1047–1054.

    Article  CAS  PubMed  Google Scholar 

  • Gross, C. R., Messersmith, E. E., Hong, B. A., Jowsey, S. G., Jacobs, C., Gillespie, B. W., & RELIVE Study Group. (2013). Health-related quality of life in kidney donors from the last five decades: Results from the RELIVE study. American Journal of Transplantation, 13, 2924–2934.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Hebden, L., Balestracci, K., McGeechan, K., Denney-Wilson, E., Harris, M., Bauman, A., & Allman-Farinelli, M. (2013). ‘TXT2BFiT’ a mobile phone-based healthy lifestyle program for preventing unhealthy weight gain in young adults: Study protocol for a randomized controlled trial. Trials, 14, 75–83.

    Article  PubMed Central  PubMed  Google Scholar 

  • Jacobson, N. S., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12–19.

    Article  CAS  PubMed  Google Scholar 

  • Jowsey, S.G., Jacobs, C., Gross, C.R., Hong, B.A., Messersmith, E.E., Gillespie, B.W., … the RELIVE Study Group. (2014). Emotional well-being of living kidney donors: Findings from the RELIVE Study. American Journal of Transplantation, 14, 2535–2544.

  • Klarenbach, S., Gill, J. S., Knoll, G., Caulfield, T., Boudville, N., Prasad, G. V., … Donor Nephrectomy Outcomes Research (DONOR) Network. (2014). Economic consequences incurred by living kidney donors: A Canadian multi-center prospective study. American Journal of Transplantation, 14, 916–922.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Leichtman, A., Abecassis, M., Barr, M., Charlton, M., Cohen, D., … Matas, A.J. (2011). Living kidney donor follow-up: state-of-the-art and future directions, conference summary and recommendations. American Journal of Transplantation, 11, 2561–2568.

  • Mandelbrot, D. A., Pavlakis, M., Danovitch, G. M., Johnson, S. R., Karp, S. J., Khwaja, K., … Rodrigue, J. R. (2007). The medical evaluation of living kidney donors: A survey of US transplant centers. American Journal of Transplantation, 7, 2333–2343.

    Article  CAS  PubMed  Google Scholar 

  • Mandelbrot, D. A., Pavlakis, M., Karp, S. J., Johnson, S. R., Hanto, D. W., & Rodrigue, J. R. (2009). Practices and barriers in long-term living kidney donor follow-up: A survey of U.S. transplant centers. Transplantation, 88, 855–860.

    Article  PubMed  Google Scholar 

  • Messersmith, E. E., Gross, C. R., Beil, C. A., Gillespie, B. W., Jacobs, C., Taler, S. J., … the RELIVE Study Group. (2014). Satisfaction with life among living kidney donors: A RELIVE study of long-term donor outcomes. Transplantation, 98, 1294–1300.

    Article  PubMed  Google Scholar 

  • Mjøen, G., Hallan, S., Hartmann, A., et al. (2014). Long-term risks for kidney donors. Kidney International, 86, 162–167.

    Article  PubMed  Google Scholar 

  • Muzaale, A. D., Massie, A. B., Wang, M. C., et al. (2014). Risk of end-stage renal disease following live kidney donation. Journal of the American Medical Association, 311, 579–586.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Ommen, E. S., LaPointe Rudow, D., Medapalli, R. K., Schröppel, B., & Murphy, B. (2011). When good intentions are not enough: Obtaining follow-up data in living kidney donors. American Journal of Transplantation, 11, 2575–2581.

    Article  CAS  PubMed  Google Scholar 

  • Organ Procurement and Transplantation Network (OPTN). (2013). Policy 12.0: Living donation. http://optn.transplant.hrsa.gov/converge/policiesandbylaws2/policies/pdfs/policy_172.pdf. Accessed January 17, 2015.

  • Organ Procurement and Transplantation Network (OPTN) and Scientific Registry of Transplant Recipients (SRTR). (2014). OPTN/SRTR 2012 Annual Data Report. Rockville, MD: Department of Health and Human Services, Health Resources and Services Administration, Healthcare Systems Bureau, Division of Transplantation.

  • Papachristou, C., Walter, M., Schmid, G., Frommer, J., & Klapp, B. F. (2009). Living donor liver transplantation and its effect on the donor-recipient relationship: A qualitative interview study with donors. Clinical Transplantation, 23, 382–391.

    Article  CAS  PubMed  Google Scholar 

  • Parekh, A. M., Gordon, E. J., Garg, A. X., Waterman, A. D., Kulkarni, S., & Parikh, C. R. (2008). Living kidney donor informed consent practices vary between US and non-US centers. Nephrology Dialysis Transplantation, 23, 3316–3324.

    Article  PubMed Central  Google Scholar 

  • Rodrigue, J. R., Pavlakis, M., Danovitch, G. M., Johnson, S. R., Karp, S. J., Khwaja, K., … Mandelbrot, D. A. (2007). Evaluating living kidney donors: Relationship types, psychosocial criteria, and consent processes at US transplant programs. American Journal of Transplantation, 7, 2326–2332.

    Article  CAS  PubMed  Google Scholar 

  • Schold, J.D., Buccini, L.D., Rodrigue, J.R., Mandelbrot, D., Goldfarb, D.A., Flechner, S.M., Kayler, L.K., & Poggio, E.D. (2015). Critical factors associated with missing follow-up data for living kidney donors in the United States. Clinical Journal of the American Society of Nephrology. doi:10.1111/ajt.13282.

  • Schroder, N. M., McDonald, L. A., Etringer, G., & Snyders, M. (2008). Consideration of psychosocial factors in the evaluation of living donors. Progress in Transplantation, 18, 41–48.

    Article  PubMed  Google Scholar 

  • Thiessen, C., Kim, Y. A., Formica, R., Bia, M., & Kulkarni, S. (2013). Written informed consent for living kidney donors: Practices and compliance with CMS and OPTN requirements. American Journal of Transplantation, 13, 2713–2721.

    Article  CAS  PubMed  Google Scholar 

  • Waits, S. A., Hilliard, P., Sheetz, K. H., Sung, R. S., & Englesbe, M. J. (2015). Building the case for enhanced recovery protocols in living kidney donors. Transplantation, 99, 405–408.

    Article  PubMed  Google Scholar 

  • Ware, J. E., Kosinski, M., & Dewey, J. E. (2000). How to score version two of the SF-36 Health Survey. Lincoln, RI: QualityMetric Inc.

    Google Scholar 

  • Waterman, A. D., Dew, M. A., Davis, C. L., McCabe, M., Wainright, J. L., Forland, C. L., … Cooper, M. (2013). Living-donor follow-up attitudes and practices in U.S. kidney and liver donor programs. Transplantation, 95, 883–888.

    Article  PubMed  Google Scholar 

  • Weng, F. L., Reese, P. P., Waterman, A. D., Soto, A. G., Demissie, K., & Mulgaonkar, S. (2012). Health care follow-up by live kidney donors more than three yr post-nephrectomy. Clinical Transplantation, 26, E300–E306.

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Acknowledgments

We are grateful to the following individuals for their assistance in the implementation of this initiative: Jonathan Berkman, Jodi-Ann Dattadeen, Lauren Finnigan, Betsy Gray-Chrzan, Douglas Hanto, Alexa Hiley, Linda Lentz, Maeve Moore, Matthew Paek, Denny Tsai, and Linda Walsh. Preparation of this article was supported by Award Number R01DK085185 (Rodrigue, Mandelbrot, Pavlakis) from the National Institute of Diabetes and Digestive and Kidney Diseases. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Diabetes and Digestive and Kidney Diseases or the National Institutes of Health.

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation of the Beth Israel Deaconess Medical Center whose Institutional Review Board approved the protocol for data collection and use as “Exempt,” and so ruled that informed consent was not required. Additionally, all procedures followed were in accordance with the Helsinki Declaration of 1975, as revised in 2000.

Author information

Authors and Affiliations

  1. Center for Transplant Outcomes and Quality Improvement, Transplant Institute, Beth Israel Deaconess Medical Center, 110 Francis Street, 7th Floor, Boston, MA, 02215, USA

    James R. Rodrigue, Tanya Vishnevsky, Aaron Fleishman, Tracy Brann, Amy R. Evenson, Martha Pavlakis & Didier A. Mandelbrot

  2. Harvard Medical School, Boston, MA, USA

    James R. Rodrigue, Amy R. Evenson, Martha Pavlakis & Didier A. Mandelbrot

Authors
  1. James R. Rodrigue
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tanya Vishnevsky
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Aaron Fleishman
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tracy Brann
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Amy R. Evenson
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Martha Pavlakis
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Didier A. Mandelbrot
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to James R. Rodrigue.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rodrigue, J.R., Vishnevsky, T., Fleishman, A. et al. Patient-Reported Outcomes Following Living Kidney Donation: A Single Center Experience. J Clin Psychol Med Settings 22, 160–168 (2015). https://doi.org/10.1007/s10880-015-9424-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10880-015-9424-9

Keywords

Search

Navigation